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THE MEDICINE SHOPPE #708
FP75090 Your Health Clinic
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Covered Entity Details
Entity Name
Your Health Clinic
Subdivision Name
Type
Family Planning (Title X only)
340B ID
FP75090
Entity Address
1521 Baker Rd
Sherman, TX 75090-2409
Grant Number
FPHPA006521
Participating Start Date
1/1/2019
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
THE MEDICINE SHOPPE #708
Pharmacy Address
1624 N. TRAVIS ST.
SHERMAN, TX 75092-3762
Pharmacy Comments
Contract Details
Approval Date
7/10/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gwynne Palmore, Executive Director
(903) 891-1972
Contract Pharmacy Representative
Nota Consulting Group, LLC
Fungisai Nota, 340B Program Manager
(610) 742-7763
Signed By Date
7/10/2019
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